围手术期肠外营养支持在胃癌根治术的应用

1986～1988年的胃癌扩大根治术221例及根治性全胃切除术19例非肠外营养(N-TPN)支持为对照组,与1991～1993年的198例及61例施行TPN治疗为实验组进行对比。N-TPN组术后并发症总发生率为7.2％,TPN组则为2.0％;全胃切除术并发症发生率分别为31.6％和4.9％(P<0.01)。吻合口瘘发生率N-TPN组分别为2.7％和10.5％,而TPN组则均为0.0％(P<0.01)。膈下脓肿发生率N-TPN组为31.6％和15.8％,而TPN组则为1.5％和3.3％(P<0.05)。但本研究是回顾性的,所以要有待进行前瞻性的、对照的、随机的大范围研究。     

慢粒白血病abl癌基因表达的研究

选择分别位于ｂｃｒ／ａｂｌ嵌合基因的Ｍｂｃｒｌ第二外显子和ａｂｌ的第二外显子上的两条引物，对１８例慢粒白血病及２例急淋白血病标本进行逆转录ＰＣＲ（ＲＴ－ＰＣＲ）检测。结果：在１８例包括ｐｈ（＋）和ｐｈ（－）不同病期的慢粒白血病患者血中均检出ｂｃｒ／ａｂｌ嵌合基因的表达，其中１４例为Ｋ－２８型表达，１例为Ｌ－６型表达，３例为Ｋ－２８型，Ｌ－６型同时表达；２例急淋白血病标本中１例为Ｋ－２８型表达。研究结果表明，１．ｂｃｒ／ａｂｌ嵌合基因是慢粒白血病的一个重要分子生物学特征；２．ｐｈ（＋）和ｐｈ（－）慢粒白血病的分子生物学基础相同，即均有ｂｃｒ／ａｂｌ嵌合基因；３．至少部分急淋白血病与慢粒白血病有相同的分子生物学基础；４．ｂｃｒ的断裂点位置可能有一定的临床意义，但有待进一步研究；５．同时表达Ｌ－６型和Ｋ－２８型的情况多见于急变区，此现象提示体内可能同时有两类不同嵌合的白血病细胞或白血病急变期ｂｃｒ出现新的重排。     

THE ROLE OF P_1-PURINERGIC RECEPTORS IN THE SPINAL MECHANISMS OF ACUPUNCTURE ANALGESIA

It has been extensively proved that electro-acupuncture elicit analgesia in bothextensive areas and local region via supraspinal structures and spinal cord.The present investigationwas to study the role of P_1-purinergic receptors in the spinal mechanisms of weak electroacupuncture-induced analgesia.Leg withdrawal latency(LWL)to noxious radiant heat focused on the ankle regionwas used to assess the effects of acupuncture and that of P_1-purinergic(adenosine)receptor antago-nists,theophylline and caffeine on the electro-acupuncture(EA)analgesia.EA prolonged the LWLby 16.7%±20.3%,with an after-effect lasting about 15 min.Both theophylline and caffeineblocked the EA-induced prolongation of LWL in a dose-dependent manner at the doses of 1.6-16 mg/kg.These results suggest that P_1-purinegic receptor is involved in the spinal mechanisms of weak EAproduced analgesia in the rat.     

黄疸出血群赖型017株钩端螺旋体外膜单克隆抗体免疫...

BALB/c mice were immunized intraperitoneally with outer envelopes of serogroup icterohaemorrhagiae lai serovar strain 017 leptospires. Monoclonal antibodies against outer envelopes (IgG, agglutinating titre 1:25,600) were produced by hybridoma technique. The monoclonal antibodies ascites (diluted 1:100) 1 ml administered intraperitoneally 1 hour before the intraperitoneal injection of 2 x 10(8) leptospires of strain 017 and the subsequent daily administration of McAb in similar doses for five days protected 80% of guinea pigs. Survival rates of three control groups which received physiological saline, ascites of BALB/c mouse myeloma cell lines SP2/0, and monoclonal antibodies against Pseudomonas aeruginosa in place of monoclonal antibodies against outer envelopes of strain 017 leptospires were 10%, 20% and 10% respectively. When killed 20 days after challenge, guinea pigs of experiment group were normal at autopsy. Old pulmonary haemorrhage were present in the animals of three control groups. Passive immunoprotection experiments have demonstrated immunoprotection of monoclonal antibodies against outer envelopes of strain 017 leptospires. It will be valuable for separating protective antigen fraction of outer envelopes and studying new vaccine of leptospira.     

Subtypes of alpha 1-adrenoceptors in rat blood vessels

Two alpha 1-adrenoceptor subtypes (alpha 1A and alpha 1B) have been distinguished by competitive antagonists and the alkylating agent chloroethylclonidine. The chloroethylclonidine-insensitive subtype (alpha 1A) has been suggested to selectively activate Ca2+ influx through dihydropyridine-sensitive channels in smooth muscle. We compared the effects of chloroethylclonidine and nifedipine on contractile responses to norepinephrine (NE) in rat blood vessels. Pretreatment with chloroethylclonidine caused a large shift to the right and decrease in maximum for NE-induced contractions of rat aorta, however, nifedipine had no effect in this tissue. Chloroethylclonidine had no effect on NE-induced contractions of rat renal arteries, which were almost completely abolished by nifedipine. Both chloroethylclonidine and nifedipine partially attenuated NE-induced contractions in rat mesenteric artery and portal vein. Addition of nifedipine abolished residual contractions remaining after chloroethylclonidine pretreatment in all four types of vessels. The pA2 for the competitive antagonist WB 4101 was highest in renal artery and lowest in aorta. These results suggest that the sensitivity of rat blood vessels to chloroethylclonidine is inversely related to their sensitivity to nifedipine, and support the existence of two alpha 1-adrenoceptor subtypes in rat blood vessels. Rat aorta appears to contain primarily alpha 1B receptors, renal artery primarily alpha 1A, and mesenteric artery and portal vein mixtures alpha 1A of and alpha 1B.     

糖皮质激素受体高、低亲和力位点在急性淋巴细胞性白血病治疗中的意义

研究了１０例正常人和２９例急性淋巴细胞性白血病（急淋）患者外周血糖皮质激素受体高、低亲和力结合位，或（ＧＣＲＨ、ＧＣＲＬ），利用Ｒｕ３８４８６对ＧＣＲＬ进行封闭，对部分患者ＧＣＲＨ、ＧＣＲＬ在激素联合化疗前后水平的变化进行了动态观察。结果表明，正常对照组ＧＣＲＨ、ＧＣＲＬ分别为４６０８±１８８９位点／细胞和１３５２３８±８８５０９位点／细胞，两者相关良好。急淋患者ＧＣＲＨ、ＧＣＲＬ分别为６０５２±３８８８位点／细胞和１２６４０５±１０２１３３位点／细胞，经过糖皮质激素药物联合化疗后，其水平分别为３６１６±１９６２位点／细胞和１４３５９７±１１２２８９位点／细胞，ＧＣＲＨ下降明显（Ｐ＜０．０１），下降率为４０．３％；而ＧＣＲＬ化疗前后差异不显著（Ｐ＞０．０５）。提示ＧＣＲＬ在介导糖皮质激素联合化疗疗效的维持中起重要的作用。     

鼻内法鼻泪管阻塞切除术

本文介绍了鼻内法鼻泪管逆行切除术的切除器制备、应用器械、手术方法及术后处理。并应用本法治疗慢性泪囊炎１０６例１１３眼，术后随访１￣５年，痊愈９３．８％，无效６．２％。     

384例女青年乳房形态学调查

对384例未婚女青年的双侧乳房进行了调查研究,提供了有关乳房、乳头、乳晕的形态、大小和位置等各项重要的测量数据,可供乳房成形术时参考。     

孕妇血浆尿酸正常值及其在妊娠高血压综合征的诊断价值

测定了133名正常孕妇和133名妊高征患者的血浆尿酸,其平均值分别为324.00μmol/L和388.91μmol/L,有显著性差异,且尿酸增高程度与病情轻重有关,但两组尿酸分布大部分重叠。确定了孕妇血浆尿酸的95％正常值上限为445μmol/L,在此基础上评价了尿酸对妊高征的诊断价值,认为血浆尿酸只适合用于判断妊高征病情严重程度,不宜用于妊高征的诊断和鉴别诊断。     

Surgical Management of PICA Aneurysm and Incidental Facial Nerve Schwannoma: Case Report.

We report a patient with a posterior inferior cerebellar artery (PICA) aneurysm and an incidental facial nerve schwannoma at the cerebellopontine angle (CPA). A 46-year-old woman presented with the sudden onset of a severe headache, nausea, and vomiting. She had no other abnormal neurological symptoms and signs. Computed tomography (CT) showed hemorrhage in the fourth ventricle. Cerebral angiography demonstrated an aneurysm arising from the tonsillomedullary segment of the left PICA. A facial nerve schwannoma was incidentally found as the aneurysm was being clipped. The aneurysm was clipped via a left transcondylar approach. Subsequently, the schwannoma (2 x 3 x 2 mm) was resected from the facial nerve fascicles, and the facial nerve was preserved. Postoperatively, the patient developed mild to moderate dysfunction of the facial nerve (House-Brackmann grade III [H-B III]) but her hearing was intact. Both a facial nerve schwannoma involving the CPA and an aneurysm involving the PICA can be managed through the transcondylar approach. An asymptomatic facial nerve schwannoma can be resected safely with minimal facial nerve dysfunction.